Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 18:10:942455.
doi: 10.3389/fped.2022.942455. eCollection 2022.

Anakinra treatment in multisystemic inflammatory syndrome in children (MIS-C) associated with COVID-19

Şengül Çaǧlayan  1 , Hafize Emine Sönmez  2 , Gülçin Otar Yener  3 , Esra Baǧlan  4 , Kübra Öztürk  5 , Kadir Ulu  1 , Vafa Guliyeva  6 , Demet Demirkol  7 , Mustafa Çakan  1 , Semanur Özdel  4 , Hulya Bukulmez  8 , Nuray Aktay Ayaz  6 , Betül Sözeri  1
Affiliations

Anakinra treatment in multisystemic inflammatory syndrome in children (MIS-C) associated with COVID-19

Şengül Çaǧlayan et al. Front Pediatr. .

Abstract

Objective: The study aimed to report the efficacy and safety of anakinra treatment in patients with the refractory multisystemic inflammatory syndrome in children (MIS-C).

Methods: This is a cross-sectional retrospective study consisting of pediatric patients diagnosed with MIS-C who were treated with anakinra.

Results: Among the 378 patients diagnosed with MIS-C, 82 patients (21.6%) who were treated with anakinra were included in the study. The median age of patients was 115 (6-214) months. The median duration of hospitalization was 15 (6-42) days. Sixty patients (73.1%) were admitted to the pediatric intensive care unit. Patients were treated with a median dose of 2.7 mg/kg/day anakinra concomitant with IVIG and steroids. Intravenous anakinra was applied to 12 patients while 70 patients received it subcutaneously. Twenty-eight patients required high dose (4-10 mg/kg/day) anakinra. The median day of anakinra initiation was 2 (1-14) days and the median duration of anakinra use was 7 (1-41) days. No injection site reactions were observed while elevated transaminase levels were detected in 13 patients. Seventy-three patients (89.1%) were discharged without any sequela or morbidity. Seven patients (1.8%) died. Abnormal echocardiographic findings continued in two patients (2.4%) (coronary artery dilatation in one, low ejection fraction in one) at discharge and became normal on the 2nd month.

Conclusion: Based on the results of the study, anakinra was associated with clinical improvements and was safe for most patients with refractory MIS-C.

Keywords: COVID-19; anakinra; multisystem inflammatory syndrome in children (MIS-C); refractory MIS-C; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The daily variation of median laboratory values under anakinra treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatoryshock in children during COVID-19 pandemic. Lancet. (2020) 395:1607–8. 10.1016/S0140-6736(20)31094-1 - DOI - PMC - PubMed
    1. CDC . Health department-reported cases of multisystem inflammatory syndrome in children (MIS-C) in the United States. (2021). Available online at: https://www.cdc.gov/mis/cases/index.html (accessed December 2021).
    1. Tran VL, Parsons S, Nuibe A. The Trilogy of SARS-CoV-2 in Pediatrics (Part 2): Multisystem Inflammatory Syndrome in Children. J Pediatr Pharmacol Ther. (2021) 26:318–338. 10.5863/1551-6776-26.4.318 - DOI - PMC - PubMed
    1. Dhaliwal M, Tyagi R, Malhotra P, Barman P, Loganathan SK, Sharma J, et al. . Mechanisms of Immune Dysregulation in COVID-19 Are Different From SARS and MERS: A Perspective in Context of Kawasaki Disease and MIS-C. Front Pediatr. (2022) 10:790273. 10.3389/fped.2022.790273 - DOI - PMC - PubMed
    1. Wahezi DM, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, et al. . American college of rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: Version 1. Arthritis Rheumatol. (2020) 72:1809–19. 10.1002/art.41454 - DOI - PMC - PubMed

LinkOut - more resources